Individual
KAYLEE PETERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
25300 S 4210 RD, INOLA, OK 74036-5032
(918) 948-2712
Mailing address
25300 S 4210 RD, INOLA, OK 74036-5032
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
5441
OK
Other
Enumeration date
07/02/2020
Last updated
07/02/2020
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